Effects of naturalistic psychedelic use on executive functioning: An online survey of lifetime history and recent use...

Classic psychedelics such as psilocybin and LSD have shown therapeutic potential for a variety of substance use and mental health disorders. Emerging evidence suggests that psychedelics may enhance cognitive function post-acutely, potentially contributing to their therapeutic effects. However, few studies have examined this in naturalistic settings. This cross-sectional study compared differences in executive functioning between individuals who reported lifetime or recent (past 6 months) psychedelic use and those who reported no history of use.

A total of 1342 university students completed an online version of the Wisconsin Card Sorting Task (CST), and self-reported psychedelic and other substance use as part of an online study. Robust linear regressions tested group differences and, among lifetime psychedelic users, effects of use characteristics (number of uses, typical dose) on CST outcomes.

Compared to non-users, lifetime (n = 224) and recent (n = 114) users performed better on all CST measures except perseverative errors, showing fewer perseverative responses, total errors, and non-perseverative errors, as well as more conceptual-level responses and categories achieved. Among psychedelic users, number of lifetime uses was unrelated to CST outcomes, and moderate-dose users completed more categories than low-dose users, with no other dose-related effects.

Lifetime and recent psychedelic use were associated with better executive functioning, independent of total lifetime use. These data provide first evidence in a naturalistic setting that these effects may be dose-sensitive. Future research is warranted to examine cognitive mechanisms underlying the potential therapeutic benefits of classic psychedelics across cognitive domains and clinical populations.